In our latest blog series, we’ll be taking a look at how the ACG System’s suite of tools can be used to understand emergency department (ED) visits and in turn, optimize health care utilization and reduce potential costs.
If you read last week’s blog, you know that the ACG System can reveal specific trends in ED visits for a certain population, specifically, patients who visited for non-emergent care or primary care (PCP) treatable conditions. By drilling down into this data, ACG System users can understand root causes of ED use and segment patients into groups depending on their unique health care needs. With this information in hand, System users can develop an effective strategy to reduce ED use and associated health care costs.
Following a detailed, ACG-driven analysis and plan, System users can use granular patient-level outputs to develop and deploy tactics to reduce potentially-avoidable ED visits. Patients with multiple ED visits for PCP-treatable diagnoses may benefit from outreach from their PCP, or assistance locating and working with a PCP if they do not have an existing relationship. The organization may wish to assess systemic access barriers as well, such as transportation challenges, PCP office hours/appointment availability, or prohibitively high co-pay for a PCP visit.
Another impactable patient group are those visiting ED departments for non-emergent diagnoses. ACG System users can identify and target relatively healthy patients (those with lower RUB* levels, for instance) with educational campaigns and incentives for PCP visits. Likewise, individuals with more complex needs, multiple chronic conditions, or care coordination challenges (RUB 4 or 5) can be directed to targeted preventive services and guidance from their PCP. The ability to tailor a specific approach to a specific group of patients maximizes impact while meeting patient-specific care needs.
The diagram below shows how the ACG System can segment a general set of data (avoidable ED visits) into its various, specific components. With each level of segmentation, the data filters into more and more precise groups, who can be targeted for specific interventions.
Ultimately, when ACG System users understand causes and trends in ED use at this granular level, they can proactively target patients with potentially-avoidable visits and deploy interventions to reduce avoidable ED use. The result? Improved access to PCPs and lower unnecessary ED visits.
*RUB = Resource Utilization Band, a category of expected health (care need as defined by the ACG System (1 = low; 5 = high)
Want to take an even deeper dive into how the ACG System can help classify your ED visit data? Read a case study from Israel’s Clalit Health Services here.